College for Seniors
Registration Form ~ Spring 2006
Persons age 50 and above may register.
PLEASE PRINT ( form may be duplicated for additional registrations)
(A spouse or friend also may register for courses using this same form. Fill in all information below.)
Participant #1
Participant #2
Address
Address
City
Zip
Phone (
City
)
Phone (
E-Mail
Zip
)
E-Mail
Physician
Phone (
)
Physician
Please mark your preference(s)
Phone (
)
Participant #1 Participant #2
#1 Iowa Roots: African American History in Iowa 1838-2000 @ $55
___ Textbook @ $35
#2 Energy @ $55
#3 More Newsroom Cubs and Literary Giants @$55
#4 Great Decisions ‘06 @ $55
___ Study Guide @ $18
___ Postage for Guide to be mailed prior to class @ $4
#5 Listening to Music Beyond* the Sound @ $55
#6 Geology of Iowa @ $55
#7 Wake Up Your Garden For Spring @ $55
#8
#9
#10
#11
#12
#13
#14
Voyages of Discovery: In Our Solar System @ $55
Bridge-The Diamond Series@ $55
Bridge -The Spades Series @ $55
Aspects of European Theater History @ $55
This We Believe @ $55
Political Issues @ $55
Exploring Industry in Ames @ $60
If requested classes are full, my second choices are:
Class #___ Participant’s name ________________________________
Class # ___ Participant’s name ________________________________
Amount of tuition and materials/postage
$
$
Total amount of check.
$
$
Be sure to check the date, time and location of the courses you want in the class description section. Enter the
appropriate tuition amount for each participant, and then enter the amount remitted. One check may be written
for both participants. Please make check or money order payable to the College for Seniors and send it with the
completed registration form to: College for Seniors, 88 Scheman Building, Ames, IA 50011-1112.
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